Don’t Blur the Message on Cancer Screening

I hope this week’s headlines and editorials don’t add to the blurriness of the public’s perception of cancer screening – that people might begin to think it’s a bad thing all around. The details matter….screening if it’s done right can save lives and dollars. That’s because for most tumor types, treating advanced, metastatic disease is costlier than treatment of early-stage, curable tumors.

New Article on Mammography Spawns False Hope That Breast Cancer is Not a Dangerous Disease

Few forms of invasive breast cancer warrant no treatment unless the patient is so old that she is likely to die first of another condition, or the patient prefers to die of the disease….“Mammograms Spot Cancers That May Not Be Dangerous,” said WebMD, yesterday. This is feel-good news, and largely wishful.

New Numbers Should Factor Into the Mammography Equation

On Friday the New York Times reported that surgeons are performing far too many open breast biopsies to evaluate abnormal mammogram results. A new American Journal of Surgery article analyzed data for 172,342 outpatient breast biopsies in the state of Florida. The main finding is that between 2003 and 2008, surgeons performed open biopsies in an operating room – as opposed to less invasive, safer biopsies with needles – in 30 percent of women with abnormal breast images.

I was truly surprised by this should-be outdated statistic, which further tips the mammography math equation in favor or screening.

It’s Not About the Money

If physicians’ potential profit motives cloud the mammography debate, as the authors contend, that doesn’t mean that mammography is ineffective. Rather it signifies that doctors and scientists should analyze data and make clinical decisions in the absence of financial or other conflicts of interest.

What’s Missing in the Recent Mammography Value Study

I’d say the oppo­site is true: It’s pre­cisely because there are effec­tive treat­ments for early-stage dis­ease that it’s worth find­ing breast can­cer early. Oth­er­wise, what would be the point?

Metasta­tic breast can­cer is quite costly to treat and, even with some avail­able tar­geted ther­a­pies, remains

Stepping Back, and Thinking Forward to October

A question central to today’s discussion – which does at least acknowledge the decline in breast cancer mortality – is the extent to which mammography is responsible for this trend, as opposed to other factors such as increased awareness about cancer, better cancer treatments and other variables.

Another Erroneous Report on Breast Cancer Screening by Mammography

What the authors tried to do was analyze trends in breast cancer mortality in relation to mammography’s availability in distinct regions of Denmark over several decades. Using Poisson regression, a form of statistical analysis, they looked for a correlation and found none. They concluded that they couldn’t detect a benefit of screening mammograms among Danish women who might benefit (see below).

Here’s what I think are the two most serious flaws in this observational study:

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